Immunology Final QS-Part1

1) commitment to γδ - gamma, delta - lineage of T of  T cells occurs in which the following developmental stage: - DN -CD4+CD8+ DP - SP - mature naïve T cell 2) What the difference between memory & naïve cells: - Memory cells recirculate between blood & tissues, naïve between blood & L.N. 3) IL-2 activates: - JAK5, STAT1 & STAT3 4) All 4)  All of the of  the following will not protect from tumor formation tumor  formation except (i.e. which one protects from tumors) a) CD8 cells reacting to tumor antigens tumor  antigens [all other answers other answers were the evasion mechanisms] - Introduction of tetanus of  tetanus toxoid is classified as ………… immunity a) arti artifi ficia ciall active b) artificial passive c) natural active d) natural passive e) acquired active 5) Which of the of  the following is mismatched a) IL-10 : mas ma st cells b) IL-6 : Th2 cells 6) The mechanism that breakdown peripheral tolerance: - Molecular mimicry. Molecular  mimicry. 7)  Autoantibodi  Autoan tibodies es bind a glycoprotein in the basement membrane of  the lung & glomeruli this occur in: occur in: - Goodpasture's syndrome 8) C-ANCA: - Wegener's granulomatosis 9) The gene that cause cancer:

- Oncogene 10) DiGeorge syndrome is: - Monogenic 11) The disease that defect in actin cytoskeleton: - Wiskott-Aldrich syndrome 12) Promote transcription of HIV of  HIV genes: - NF-Kb, NF-AT 13- not a cause of secondary of  secondary immune deficiency : - Genetic mutation

14) the best place we can get stem cell from it: - Cord blood 15) the most challenge at Bone marrow transplantation: - graft versus host reaction –GVHDreaction  –GVHD- . 16) Cyclosporine & tacrolimus are: - T-cell signaling Blockade 17) Carcino-embryonic antigens are: - Developmental proteins 18) To increase the half-life of INF-a of  INF-a we add: - Polyethylene glycol (PEG) 19- Interlukein 12 is secreted from which cell: - Macrophage 20- complement defects lead to : - neiss nei sseri eria a infect inf ectio ions ns 21- What is the tissue typing technique that is used to detect antibodies against donor H donor HLA : - HLA HL A cross mat ma tching hi ng 23- cyclosporine acts on : - T Cell activation at calcinourea

24- The disadventage of using of  using muse monoclonal antibodies : - the huma hu man n body produ od uces anti mouse mou se antibo ant ibodie dies s 25 - the disease that improves during pregnancy is : - Multiple sclerosis - SLE 26 - the tendency to have IgE response ……… is called: -  Allergy - hypersensitivity -atopy 27- all are peripheral tolerance mechanisms except: T-cell killing in the thymus

Cases : 28 - a boy was playing outside , days after he after  he comes home he developed rash and irritation of the of  the skin........................ , this type of hypersensitivity of  hypersensitivity : - Delayed hypersensitivity contact dermatitis . 29 - a man 60 years old had a BM transplantation , the operation was successful , 2-3 days after the after  the operation the man developed jundice developed  jundice ,diarrhea, hematouria the type of this of  this rejection is : - hyperacute rejection - acute Graft-Versus- Host disease - chronic Graft-Versus- Host disease - chronic rejection 30 - a case about kidney disease , in the tests there was antibodies against glomerulus basement membrane : - Goodpasture syndrome syndrome..

31 – 31  – case … the lab test showed that the patient had c-ANCA, what's the diagnosis? Wegener's Granulomatosis. 32 - Which of the of  the following is wrong about adjuvants a) they act as antigen depot b) they prolong the contact time with antigen

c) they make any molecule immunogenic d) they cause local ca l inflammation 33 -  AB+ child was born to an ABan  AB- mother, he had jaundice, had jaundice, fever and fever and splenomegaly, direct coomb's test result will be: a) Anti-Rh a)  Anti-Rh antibodies bound to the mother's erythrocytes b) Anti Anti-R -Rh h anti an tibo bodi dies es boun bo und d to the th e infa in fant nt's 's eryt er ythr hroc ocyt ytes es c) Anti-A c)  Anti-A and Anti-B and Anti-B in the infant's serum 34- RAG-1 and RAG-2 are downregulated in some stages of B-cell of  B-cell development, so th at each B cell will have only one specificity. The underlying mechanism is a) somatic hypermutation b) class switching c) affinity maturation d) alle allelilic c excl ex clus usio ion n 35 -  Aspirin mediates its effects through blocking the synthesis of  a) leuktriens b) prosta pro stagla glandin ndins s c) histamine 36 -  A person had a rare pan-T-cell deficiency. On performing flow cytometry by the FACS machine, which cell marker will marker will be the least in number ? number  ? a) CD19 b) CD3 c) CD5 d) CD11a 37 - Certain skin diseases are a result of  high number of  number  of  activated T cells. One hypothesis says that we can use the tetanus toxoid to fight these disease. Which of the of  the following cytokines can give the best results if conjugated if conjugated to the toxoid ? a) IL-2 b) TNF-a TNF -alp lpha ha c) IL-4 d) IFN-gamma 38 -Which of the of  the following cytokines will be most numerous in the brain of a of  a patient with multiple sclerosis ? a) IL-2 and IFN-gamma

39 - [A case about rheumatoid arthritis] The patient has  joint pain in the ankles, wrists. The rheumatoid factor in factor  in serum = 100 , ESR = (elevated). Which of the of  the following antibodies mainly contributes to the pathogenesis of the of  the disease ? a) IgM against IgG b) IgA against synovial cells c) IgM against histones d) IgG against dsDNA e) IgG against topoisomerase I enzyme. 40 -  A patient has undergone stem cell transplantation. He didn't show any signs of rejection of  rejection for 3 for  3 days, then he had some macular yellow macular  yellow rashes on the skin, with abnormal liver function liver  function test, abnormal creatinine, (…many things!). What's most probably happening ? a) Hyperacute graft rejection b) acute graft rejection c) acut cu te GVHD GV HD d)chronic GVHD e) chronic rejection

41 ) The disorder related disorder related to abnormal actin function is: a) Wiskot-Aldrich syndrome. -  A patient with staphylococcal infection had normal IgM but low IgA, IgG levels in serum. Which of the of  the following is deficient? a) CD(B7) b) CD80 c) CD40 d) CD40 CD40L L 42 ) Ciclosporin and tacrolimus belong to which class of immunosuppressants of  immunosuppressants ? a) antiprolirferatives b) IL-2 blockers c) T-cel T-c elll signali sign aling ng blocka blo ckade de d) corticosteroids 43 ) [A case about glomerulonephritis] the patient had elevated blood urea nitrogen, bronchospasm, reddish urine, the diagnosis was rapidly propagating glomerulonephritis. Which of the of  the following is ture? a) there should be a lot of mast of  mast cells in the tissue b) there are antibodies reacting against tissue antigens 44) In cross-matching, we use: a)indirect coomb coomb's 's test te st

b) direct coomb's test 45) All 45)  All of the of  the following are likely to induce tolerance except a) anatomic sequestration b) introduction of antigen of  antigen during embryogenesis c) introduction of antigen of  antigen to immature cells d) strong binding to autoantigen e) a pat pa thogen ge n bind bi ndiing to a self el f-ant -a ntiigen ge n 46)  All of the of  the following are true about adjuvant EXCEPT: &  All of the of  the following are true about atopy EXCEPT: So you must focus in these terms .

46 ) Which drug will hopefully cause sterilizing immunity in HIV infection a) IL-7 b) IL-2 47 ) [a case] … the patient had no lymphoid progenitors…Which of these of  these is likely to be abscent?  Answer: IL-7 48) Which of the of  the following has its only Fc portion from human origins a) humanized mAbs b) chi ch imer meric mAbs mA bs c) phage libraries 49) One method to increase the half-life of IFN-apha of  IFN-apha in the treatment of  Hepatitis B is by PEGylation - The first thing to do when preparing for transplantation for transplantation is to check a) major HLA major HLA compatibility b) minor HLA minor HLA = c) ABO ABO comp co mpat atib ibililitity. y.

50) [a case]…the patient had antibodies against the basement membrane of  the kidney, what's your diagnoisis your diagnoisis ? Goodpasture's syndrome -51 ) Which cell decides the polarization of  adaptive immune response( to Th1 or Th2) or  Th2) is: a) APC b) naïve T cell c)Tregs - 52) There were two questions about the association between Chronic granulomatous disease and the NBT test. - Which of the of  the following can be produced from the MHC genes on the short arm of chromosome of  chromosome 6 a) compl compleme ement nt C3 b) complement C5 - 53) a case about SCID. Which of the of  the following is wrong? The patient's genes are normal. - 54) Monoclonal Abs Monoclonal  Abs that have the human constant region are called: - humanized - Chimeric -transgenic

-55) Case: fever, dyspnea & hemoglobinuria,, the immunofleorescense test showed linear immune linear  immune complex precipitation.. this type of autoimmune of  autoimmune disease is mediated by: - soluble Ag soluble Ag against fixed Abs fixed  Abs - stimulation of  of cells cells by autoantibodies - cell-mediated immunity & Granuloma formation -56) 9-year-old child with recuurent staphylococcal infection, differential CBC showed normal PMN count,, further tests further tests will most likely show: - complement deficiency -low CD4+ cell count - -ve NBT test 57) autopsy of aborted of  aborted fetus showed absent peripheral counts of T of  T & B cells although his BM contained normal number of  number  of  lymphoid precursors,, if  deficiency in one IL-receptor was IL-receptor  was responsible for this for  this case>> it's most likely to be: -IL-7

-IL-1 -IL-2 -IL-3 58) *the most informative sentence about mast cells: - they cause inflammation not only cuz of  of histamine histamine release but also due to metabolism of  A.A.  A.A. 59) which cytokine can induce apoptosis: -IL-1 -IL-6 -TNF 60) which makes lymphocytes & neutrophils slow or stop or stop at site of extravasation of  extravasation from blood vessels: - LFA-1 -ICAM-1 -VLA-4

61) needed for B for  B cell stimulation: - cytokines & occupation of TCR of  TCR -  Ag & cytokines - TH cell &  APC help 62) 2-year-old toddler suffering toddler suffering diarrhea, recurrent infections & failure to thrive.. his parents refused vaccines for religious for  religious reasons,, examinations revealed absent thymus gland; he has: - DiGeorge syndrome 63) Ags 63)  Ags expressed in cancer & cancer  & tissues from which they arise, belongs to which type of tumor  of  tumor  Ags:  Ags: - lineage-specific lineage-specific Ags  Ags

64) skin disorder characterized disorder  characterized by over-activation of  T-cells.. which cytokine is most likely to be used conjugated to diphtheria toxoid as a treatment for this for  this case: - Inf-γ -IL-2 -IL-4 65) NADPH oxidase deficiency leads to deficiency in which cellular component: cellular  component:

- defensin -hyp hypochl ochloru orus s aci acid d - lactoferrin -acidification of lysosymes of  lysosymes 66) tumor  Ags  Ags expressed in tissues during fetal life: - developmental Ags developmental  Ags 67) Cyclosporin mech. Of  Action:  Action: - intracellular signaling intracellular signaling blockade 68) all true except: - Igs transported in the last month of pregnancy of  pregnancy - Igs transported via specialized FcR in placenta - Igs are transported in energy-dependent mech.

69) case question: …….. a defect in the hypochlorus acid this will affect : The acidity of the of  the lysosmes 70) case question : …………… so the patient is diagnosed with few T cell count, the site in the LN that is most likely to be affected the most? Paracortical area.

71) A 71)  A boy was infected by tetanus infection , the doctor is doctor is not sure that he is protected from the tetanus so he give him a booster of  booster  of  tetanus toxoid this type of immunity of  immunity is : )- artificially active immunity

72) he most common antibodies in the mucosal surface of the of  the genital track?(from the first) IgA 73) the random addition of nucleotide of  nucleotide by TdT is in ? (from the first) Junctional diversty

74) The change in the antigen binding site to create a higher  affinity binding known as ?

Somatic hypermutaion 75 ) the child will use one chromosome from the parents chromosoms this is known as ( the question is not in this formula but the idea is this !!!)?  Allelic exclusion.

76) one of  the following is not correct about TI : ( not sure about the formula of  the question) It has a memory 77) one of the of  the following will not share in the synapse ? (from the first ) CD3

78 ) one of the of  the following is not a responsibility of the of  the anphlatoxins ????? I don’t remember the remember the choices sorry !!!!! 79) case question :…………. So he found that there are immune complexes in the kidney this an indication of : of  : SLE 80) one of the of  the following is not a cause of secondary of  secondary immune deficiency ? Mutations 81) molecules produced by tumor cell tumor  cell and can be recognized by the immune system known as ? Tumor antigens Tumor  antigens From this to END FROM HAYAT AND SHIFA EXAMS : 82) Tumor correct Tumor  correct except a) tyrosinase – tyrosinase  – melanoma b) CEA & GI cancer  c) Viral EBV – EBV  – Lymphoma d) BCR-Abl fusion protein protein –  – multiple myeloma e) Alphae)  Alpha- feto protein –hepatoma protein –hepatoma 83) HIV virus infects which cell? a) NK b) CD-8 c) B cell

d) Glial cell e) Basophile 84 ) Factor B Factor B a) Is the enzymatic part of  the C3 convertase in the alternative pathway b) Only component of complement of  complement pathway that circulate active enzyme c) Bind covalently to pathogen through thioster bond thioster  bond d) Has no potential enzymatic activity e) Cleavage factor D factor D 85 )mostly affected by INF type I (INF alpha and beta) a) Aspergellus a)  Aspergellus b) Plasmodium c) Listeria bacteria d) Staphylococcus bacteria e) Influenza virus 86) The enzyme needed in liberation of HIV of  HIV from infected cell a) Gp120 b) Protease c) Reverse transcriptase d) Integrase e) Collagenase 87)Active immunity cancer except cancer  except a) Vaccination by tumor antigen tumor  antigen b) BCG local injections c) Anti-CD20 infusion d) Vaccination by whole cell e) IL-2 infusion 88 ) serum sickness except a) C-factor  b) Monovalent Monovalentantigen antigen c) Persistence immune complex d) Nutrophils e) Equivalence of antigen of  antigen and antibody 89 ) viruses and malignancy except a) Human papilloma virus- cervical cancer  b) EBV – EBV – lymphoma c) Human herpes virus 8 and lymphoma d) HTLV-1 – HTLV-1  – acute T lymph-leukemia

e) EBV – EBV  – nasopharyngeal 90) elimination of bacteria of  bacteria by opsonization a) neutralization of bacterial of  bacterial toxin b) recognition recognitionof  of  bacteria bound antibodies by Fc receptor  receptor on on macrophage c) prevention of bacteria of  bacteria adhesion to endothelial cell d) binding antibodies Fc on bacteria e) class 1 MHC antigen 91) recombination signal sequence best describes a) sequence that contain ITAM- signaling B cell b) sequence recognized by RAG1 RAG1 –  – RAG2 c) sequence responsible for type for  type switching in B cell d) sequence encodes signal peptide responsible Ig e) sequence RNA splicing event IgM/IgD 92) MHC I and MHC II a) Constituvely expressed by most cells in the b) expressed by Macrophage Macrophageand and dentritic cell c) Constituvely associated – associated  – hapten d) Expressed – Expressed  – INF gamma

93) Injecting Complement C killing antigen-Ab in patient lacks C3 a) Depress level of serum of  serum factor B factor B b) Increased chemotactic C5a serum level c) Increased serum level of C8 of  C8 d) Decreased level of  C2 94) Trophoblast …. Immunological phenomenon except a) antibody against paternal antigens b) Increased HLA- G antigens c) Decreased MHC I d) Blocking antibody e) Increased CD8- T recognition 95) Which one is false? a) Mast cell : IL 12 b) TH2 : IL6 c) TH1 : INF gamma d) Eosinophil : IL 5

96) Regarding pregnancy, which is wrong? a) Androgen a)  Androgen suppress T/B cells b) Estrogen suppress T cells c) Placenta TH TH1 1 suppress T cell d) NK cell suppressed by increased HLA-G

97)  A 10 years old boy has recurrent skin and lung infections by staphylococcus aureus, what can be found at his diagnosis a) Low IgM, absence of B of  B cell b) Low Ig low B cell c) Low terminal complement d) Abnormal NB NBT T test 98) Pulmonary edema that follows incompatible transfusion results in a) Donor  Donor WB WBC C antibodies against recipient granulocytes 99) During B-cell development the rearrangement in Ig loci a) DH to JH JH,, DJ to VH VH,, VL to JL 100) Activation 100)  Activation of mature of  mature B cell requires two signals a) An a)  An antigen and T cell help b) TC TCR R occupancy occupancyand and T cell help??? c) Antigen and cytokines??? d) TCR occupancy and cytokines 101) The BM transplantation is the most difficult …….. a) Hyperacute b) Acute b)  Acute rejections c) GVHD d) Tolerance 102) Macrophages secretes all except a) IL- 6 b) IL-8 c) INF gamma d) TNF alpha 103) Causes tolerance rather the rather the immunity a) Insoluble antigen b) Heterologous antigen c) Particulate antigen d) Antigen d)  Antigen injected subcutaneously

e) Injecting antigen to fetus in development 104 )  Autoimmune disease a) Shows HL HLA A association b) Run a steady clinical course c) Affect c)  Affect both sexes equally d) are triggered by different antigen in different individuals 105) Cyclosporine A Cyclosporine  A inhibits a) Calcinerium 106 ) Not used as an evading mechanism by viruses a) Mutation b) Production of  cytotoxic Ab Abs s c) Downregulatin of MHC of  MHC class I molecules d) Destroying the immune system 107 ) Which on is not involved in respiratory burst pathway of  neutrophils killing a) PhospholipaseC gamma 108) Involved in stopping lymphocyte in HEV a) L-selectin b) LFA-1 109) Restriction means a) The recognition recognitionof  of  self  MH MHC C with antigen by T cells 110) Which of the of  the following is wrong regarding the fetus? a) Reversed num of pmn of  pmn and lymphocytes b) No IgM, IgA, IgG 111) Complement activation a) Activate a)  Activate hapten b) Active C1 C1q q binds antigen-antibodycomplex c) C3 convertase C4bc2b d) C3 convertase C3bBb e) Regulate factor H factor H

** The clinical boxes very important so you must focus on them.